The state of California recently agreed to refund more than $52 million in what a federal inspector general determined were “improperly claimed” Medicaid refunds for “noncitizens with unsatisfactory immigration status.”[es]”.
An audit, completed in late May but first reported Monday, underscored that federal Medicaid benefits are generally limited only to “qualified” citizens and noncitizens. Examples of qualified noncitizens are refugees, people who have been granted asylum, or those legally admitted for permanent residence.
The audit, conducted by the Department of Health and Human Services under the direction of Inspector General Christi Grimm, covered more than $372 million in federal Medicaid reimbursements made on behalf of noncitizens during fiscal year 2019. A total of $52.7 million of that sum was not filed in accordance with federal requirements.
The inspector general partly blamed an outdated calculation metric for the disparity.
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In a statement to Fox News Digital, the California Department of Health Care Services acknowledged the inspector general’s findings.
“[DHCS] plans to pay the federal government in full by June 30, 2024,” the statement reads.
“In addition, DHCS has worked with the federal Centers for Medicare and Medicaid Services to develop and implement a more refined service identification methodology with updated claims and payment processes.”
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Grimm’s report noted that MediCal – California’s state Medicaid program – offers a broader net of coverage than the federal government when it comes to noncitizens.
“Although MediCal covers full services for non-citizens with UIS, California can claim federal reimbursement only for emergency services provided to these non-citizens and would generally have to pay for non-emergency services using state funds,” it says. The report.
“According to the Centers for Medicare and Medicaid Services (CMS), in May 2020, the California Department of Health Care Services notified CMS that it had been using a long-standing CMS-approved methodology related to the claim of costs to provide full medical coverage for non-citizens with UIS… [which] applied an approximate percentage to capitation payments made to Medicaid managed care plans on behalf of noncitizens with UIS.”
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The federal Medicaid agency first requested an audit, and in May 2020, the state agency told the feds it had wrongly claimed federal reimbursement, the report said.
Illegal immigrants are also generally ineligible for federal “ObamaCare” coverage, according to HealthCare.gov.
